Provider Demographics
NPI:1275849960
Name:DOWNSTATE PERINATAL ASSOCIATE P.C.
Entity Type:Organization
Organization Name:DOWNSTATE PERINATAL ASSOCIATE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CYRUS
Authorized Official - Middle Name:O
Authorized Official - Last Name:MCCALLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-771-2992
Mailing Address - Street 1:PO BOX 1436
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-7436
Mailing Address - Country:US
Mailing Address - Phone:717-771-2992
Mailing Address - Fax:718-771-9099
Practice Address - Street 1:439 WINTHROP ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1514
Practice Address - Country:US
Practice Address - Phone:718-771-2992
Practice Address - Fax:718-771-9099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY181807207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty